Eastern Sports Medicine and Spine Associates LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

038984 Issued in CT

Legal business name

EASTERN SPORTS MEDICINE AND SPINE ASSOCIATES LLC

Practice address

2800 Tamarack Ave
Suite 104
South Windsor, CT 06074

Phone

(860) 648-0814

NPI assigned

May 6, 2015

Last updated

May 6, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cheryl Flanagan

Title

Credentialer

Phone

(860) 282-4133

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430870400000",
    "number": "1679950950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 EAST RIVER DR",
            "address_2": "5TH FLOOR",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061087301",
            "telephone_number": "860-282-4133",
            "fax_number": "860-289-0746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 TAMARACK AVE",
            "address_2": "SUITE 104",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "06074",
            "telephone_number": "860-648-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SPORTS MEDICINE AND SPINE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-06",
        "last_updated": "2015-05-06",
        "status": "A",
        "authorized_official_last_name": "FLANAGAN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "CREDENTIALER",
        "authorized_official_telephone_number": "860-282-4133"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CT",
            "license": "038984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latha Dulipsingh, MD
• Jacqueline Duncan, PT
• Meghan Dzioba
• Eastern Connecticut Medical Professionals Foundation, Inc (Eastern Orthopeadics and Sports Medicine, PC)
• Eastern Connecticut Physician Associates LLC
• Echn Wellness Services, Inc. (Women's Center for Wellness)
• Jess Edelstein, PHD
• Eden Counseling Services, LLC
• Aisha Edwards
• Sharon G. Efron, RDH, BS

• Orthopaedic Surgery Physician in South Windsor, CT
• Providers in South Windsor, CT by specialty
• Orthopaedic Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.